HomeMy WebLinkAbout0484 o ~
' Decl~ration o~ Domicile and Citizenship '
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TO THE CLERK OF' THE CIItCU1T OOURT. . .
ST. LUG 1 E ap~y. ~,pttt~~:
Thts b aq? deelatatba ot DomkU~ aad Citi:en~hip ia tUe State o~ Fbrida tlu?t I am Wing this dy ta ~ccotdaace. aad in
~oolamit~? ~Ith Seetion 222.17. Fbrida Statutes.
I~s tornxr a k~st e~eaideat ot ~iLE~+~~,~' ~ _ ~i G'.f~ aad I '
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triWed at /~`3 ~o /?D K~ ~e ~ ~ - However. I lu?w ebanged anr domie~e to
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aad am aad have beeu s ~oAa C~de resid~at ot tUe Stab at Flo~ida sinee ~ST d~,p ot
/~tU6UST .1~7? .aadlre~at ~~T -~-/•~lo ~ ~a/DMiG G ~%GG.~G~'
l8w~e ~ad Nr.b~l- .
~ - _ ST . L UG 1 E . Councy. Fb~ids.
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~ • ~ lll~i i~~EDflD~ ~S ~O b0 tiI[cA tf QI~ d1lt~ttif~IOU OI l1L~MIIIp. setud kgal nsideaee and domie~e ta tbe Statc ot Fbrida.
If fOR THE PURPOSE Oi ENRO~LING Ii i0R HOMESTEAD PURPOSES~_
CNI~OREN IN~SCN001.~ PLEASE STATE PLEASE CHECK:
TNEIR NAMESS -
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CIERK CIRCIItT pp~RT
- o~ ~n~, vEa~hED
. At~ S 210 PM'1
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~ I FUATNBR CERTIE'Y tbat I w~7i register at mr loeat addresa ~rhen the registratioa boolcs nopea. and compiy .vitb au
otl~er reqniremeats o[ s k6a! resideat o[ tl~ State.
I FUBTfIE~ CER1'IFY thit I have ao inteation to retnra to mr former domie~e. aad I Intead to remain in
! u~~r~ :y,c.c ~/i~~.~E .Car ~ i~ 6 , ST . l uc ~ E _ Count~.
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~ Floriaa, perm.n~na;. ~
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Swaa to ~ad subsertbed bcfore me lhls ~ day ot ~F~~E~c,..1 /~fi~C'.sY. ~L~4. 3 3~~~
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R C RK OF C IRCUI T COI~tT ~ ~
ST. LUG 1 E COUNTY, f LOR 1 OA ~
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. - . . - . aooK 272 Pac~ 484
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